Two Fridays ago, Lil Wayne lay in the Intensive Care Unit of Los Angeles’ Cedars Sinai Hospital, suffering from an alleged overdose of codeine-laced cough syrup. Reportedly, he was in a coma; TMZ announced that he’d been prepared for his last rites. And thus did Rap Twitter damn near fell apart. By the next day, such morbid talk proved mercifully premature. The last-rites stuff was recanted. Wayne left the hospital soon after, and late last week released an excited video to, of course, TMZ.

But please extract I Am Not a Human Being II from the huge, grim, distracting hypothetical, “What if this had been the last Lil Wayne album?” or even, “What lyrics on here hinted at his health problems.” The whole record was done and recorded before his hospitalization and, in reality it’s just the latest clump of songs to make a case for Wayne’s steady creative decline. His 10th solo album is inspired but sloppy, with a touch of mixtape Weezy, enough street-rap gusto to keep it interesting, and plenty of unfortunate glimpses of the guy who has been lyrically shitting the bed steadily these past couple years. Human Being II is mostly concerned with screwing women and feeling alienated from the rest of the world. Bleak stuff.

Also bleak: It peaks immediately. Opening track “IANAHB” is the highlight and sole true head-spinner, the lone moment to reach those dizzying Wayne-we-all-loved heights. As quasi-classy piano twinkles, he mind-melds with an increasingly avant-garde plink-plonk figure. It’s as if the rapper is playing the piano himself, his flow so empathetic and lock-step, bending his increasingly tiresome dick-suck raps into rebel yells and winding up with the sort of inspired how’d-he-think-of-this? nonsense that actually registers coherently: “Last night I took a Transformer / And had a dream that my dick turned to Megatron / But my girl was sleeping with Decepticons.” It’s a creative take on the does-a-lot-of-drugs, bitches-ain’t-shit hip-hop upon which he’s increasingly reliant.

But if Wayne can’t do weird consistently anymore, and he can’t rap like he used to — and he can’t, on both counts — then he’d be wise to keep it honest more often. Like 2011’s similarly scattered Tha Carter IV, the best moments here don’t involve him rapping his ass off so much as him getting real. “Romance” is half a Pluto-style emotional purge (“She kiss my ankle when I twist my ankle”) and half fuck-me-when-I-want-it shithead rapper talk (“She even did anal when she don’t do anal”) that nevertheless reminds us that this alien life form once oozed honesty and sincerity. On the hook to “Romance,” he even interpolates the Folger’s Coffee theme song, crooning, “They say the best part of waking up is breakfast after a nut.” It sort of ruins the song. And it also kind of makes the song.

Curt, devastating memories of his incarceration leak into a few tracks: “Spent my birthday in jail / I was making bad decisions,” he confesses on “Curtains,” while “God Bless Amerika” continues Wayne’s healthy, career-spanning habit of calling out a corrupt justice system. The message is a bit petulant — it stems from his own, comparatively minor mistreatment — but he’s pointing out that if a black superstar can be treated like garbage on the inside, then what hope is there for everyone else? It sits nicely next to his other political missives, from “Georgia… Bush” to “Tie My Hands” to “Dontgetit” to that recent, instantly legendary deposition video wherein he puckishly played dumb and clowned po-faced lawyers. If I Am Not a Human Being II were interested in making a little more sense, the record would end right here.

But there are a couple of inconsequential tracks left, and the record as a whole rolls blithely along, with Wayne delivering perfunctory but fun street-rap verse alongside some on-point guests who frequently outshine him. Any time a rapper on Wayne’s level appears, he mostly becomes negligible. The Drake- and Future-assisted “Love Me” shows just how much Wayne sounds like Drizzy these days, not the other way around; “Days and Days” and the G-Funk trap hybrid “Rich as Fuck” both prove that for pure maniacal charisma, 2 Chainz is dominating in 2013. On dubstep march “Beat the Shit,” Gunplay finds a place amid the wicky-wicky wubs, but Wayne feels a moment or two off the beat: He can’t figure out how to kill it anymore.

That Human Being II includes a dubstep song at all will induce some side-eyes; so will the actual final track here, the rap-rock debacle “Hello,” though that’s just to be expected these days. Rebirth was just three years ago. Wayne’s Young Money Cash Money label recently signed Limp Bizkit. On “Back to You,” Wayne even dares you to bristle at his wide-ranging bad taste, sampling Jamie Lidell’s “Compass” and pairing it with dude-metal guitar as he riffs on Big Freedia’s New Orleans bounce classic “Gin in My System.” At least one of those things will appeal to you a whole lot; at least one of those things will make you cringe. Like a lot of Lil Wayne’s decisions lately, it’s all very, very suspect. You’re better off soaking in the good choices here and resigning yourself to enduring the bad ones. After all, we almost lost the guy. Be happy that he’s still around at all.